Does Medicare Cover Occupational Therapy?

Many families ask whether Medicare covers occupational therapy. The short answer is that it can — depending on your situation, the reason for therapy and how your GP refers you.

Occupational therapy supports people at all stages of life. For children, it might mean building fine motor skills, improving emotional regulation or managing sensory processing. For adults, it often focuses on recovery, independence and managing long term health conditions. Understanding how funding works helps you plan any Medicare funded sessions to best achieve goals, as set by you and your GP.

When Medicare Can Assist

Medicare can contribute to the cost of occupational therapy when your GP creates a care plan for a long term or complex condition. These plans are designed to connect doctors with allied health professionals, supporting clients who need structured and ongoing care.

In July 2025, Medicare introduced a new Chronic Condition Management Plan, replacing the current Enhanced Primary Care and Chronic Disease Management system. The new plan makes it easier for GPs to refer directly to therapists and reduces paperwork and unnecessary administration.

How it Works for Children and Adults

The best place to start is always with your GP. They can help determine whether Medicare is the right funding pathway for you or your child.

Medicare can assist in instances where there is a long-term or ongoing condition that impacts day-to-day function. This might include physical, developmental, or neurological concerns that would benefit from structured allied health support. For children, this could look like:

• Delays in fine or gross motor skills
• Sensory processing or self-regulation challenges
• Autism or other neurodevelopmental diagnoses
• Difficulties with self-care, play, or school participation

For adults, occupational therapy under Medicare may support areas such as:

• Recovery after injury or surgery
• Managing chronic pain or fatigue
• Neurological conditions such as stroke or Parkinson’s disease
• Maintaining independence in daily activities, at home or at work

Your GP will advise if a care plan is appropriate and, if so, include occupational therapy sessions within it. Medicare then provides a rebate toward the cost of those sessions, helping reduce out-of-pocket expenses while keeping your care coordinated.

Other Ways To Access Occupational Therapy

Medicare isn’t the only way to access occupational therapy. Many clients use other options, such as:

• NDIS, for ongoing developmental or functional needs.
• DVA, for eligible veterans with a GP referral.
• Aged Care Packages, through My Aged Care home support.
• Private Health Insurance, depending on your extras cover.

And importantly, you don’t need any referral at all to see an occupational therapist privately. Many clients choose to self-fund their sessions. This gives full flexibility in appointment frequency, duration and therapy goals. Self funded sessions can also complement NDIS, Medicare or school based supports.

Occupational Therapy at Evolve Therapy Services

At Evolve Therapy Services, we work with both children and adults across all funding types including Medicare, NDIS, DVA, private health and self funded clients.

Our paediatric therapists support children with sensory, emotional, and developmental goals in a calm, play-based environment. For adults, we focus on practical goals such as independence, recovery and daily living skills.

We work closely with GPs, schools and families to keep therapy coordinated, purposeful and tailored to each person.

Final Thoughts

Medicare funded occupational therapy can help make seeing an OT more affordable, but it’s just one pathway. Whether you access therapy through a GP plan, the NDIS or privately, the most important thing is finding the right support for your needs.

If you’re unsure which option suits your situation, our team can help you explore what’s available and guide you through the next steps.

To find out more or book a session, get in touch with our team.